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Quick tip:Stretching can help relax and lengthen a tendon, but never stretch
the painful and inflamed area, as this can worsen the tendonitis. Instead,
stretch the more pliable muscle around the tendon.

Tendonitis.net

Achilles Tendonitis

How Achilles Tendonitis Occurs

The Achilles tendon
named after the Greek mythological character, Achilles, is the largest and
strongest Tendon in the human body. This Tendon is one of the many reasons why
we are able to walk upright. The Achilles tendon attaches the Calcaneus(heel
bone) to the Soleus-gastrocnemius complex (calf muscles). This incredibly
tough, fibrous tendon transfers the energy of the calf muscle to the force that
allows you to push your foot off of the ground. Taking a single step forward
begins at the calf muscles. The calf muscles react to nerves, connected to the
brain, that tell the muscles to contract. When the muscle contracts it places
tension on the Tendon. The Achilles tendon transfers the tension to top of the
heel bone. The tension causes the heel bone to be pulled upward. When the heel
bone is pulled upward it creates the force needed to push the foot off the
ground. Aside from the tendon pulling on the Calcaneus (heel bone), there are
many other factors which contribute to our ability to walk. The foot needs to
be stabilized laterally to keep it from rolling side to side during the process
of taking a step forward.

Achilles Tendonitis is a
condition that occurs primarily because of an overuse of the area. After
Tendonitis sets in, the Achilles tendon then becomes tight and painful. The
normal gait cycle requires the ankle to move a total of 30 degrees. The
constant movement of walking results in constant lengthening and shortening of
the tendon. This constant movement can cause inflammation and micro-trauma to
the area. The extreme shear forces placed on the insertion point of the tendon
is typically what causes Achilles Tendonitis. The insertion point is where the
tendon attaches to the Calcaneus (heel bone). The point at which the tendon
connects to the heel bone is where the maximum shear force is found. The tendon
does have the ability to stretch a small amount, but because the tendon is so
dense and fiborous is does not stretch much. When the calf muscles are tight
and tense, the tendon will be under more strain than normal. If the calf muscle
is loose, the muscles stretch further taking stress off of the tendon. Under a
microscope, an Achilles Tendon should be white, glistening and firm. An
Achilles Tendon that is plagued by Achilles Tendinitis is typically dull,
slightly brownish in color and much softer than normal.

The Achilles tendonís
origin connects the top of the calf muscle to the tendon that attaches to the
Tibia (leg bone). The tendons and the calf muscles work like a hammock. The
weight of a person laying in the hammock would pull on the support straps
(Tendons), which would cause the force of the personís weight to be transferred
into force. The tendons and calf muscles in the lower part of the leg work in
exactly the same way. The muscles contract and place force on the back of the
heel bone which pulls the foot downward allowing the person to push their foot
off the ground. The tendons act like the support straps of the hammock, but the
tendons have very little give. The hammock, itself, needs to be very elastic so
it can support the weight of the person laying in it. When a person has muscles
that are very tight, the muscle does not have enough give to allow the full
range of motion. Just like a hammock that is stretched to far, the support
straps (tendons) will be strained and can even tear. When a person has muscles
that are loose and flexible, the hammock has the ability to support much more
weight and is less likely to tear.

As mentioned previously,
Achilles Tendonitis is primarily due to a person having very tight calf muscles
during movement of the area. When the calf muscles are tight they do not react
to tension correctly. A tight calf muscle places a great deal of strain and
stress directly on the Achilles Tendon. The muscles should act as a shock
absorber for the tendon, but if the muscle is very tight the shock will not be
absorbed.

Tight muscles can occur
for many reasons. Stretching before any physical activity is always
recommended. A person that stays physically active all the time will generally
have muscles that are flexible and not as tight as someone who is not physically
active. If a person exercises and stretches daily, they will not be as prone to
Tendonitis.

Achilles Tendonitis Symptoms

Symptoms can vary from an achy pain and stiffness to the
insertion of the Achilles tendon to the heel bone (calcaneus), to a burning that surrounds the whole joint around the
inflamed thick tendon. With this condition, the pain is usually worse during and after
activity, and the tendon and joint area can become stiffer the following day.
This is especially true if your sheets are pushing down on your toes and thereby
driving your foot into what is termed plantar flexion (downward flexed foot), as
this will shorten the tendon all night.

Achilles Tendonitis Treatment

With proper care for the area, the pain in the tendon
should lessen over three weeks, but it should be noted that the healing of the
area continues and doesn't even peak until at least six weeks following the
initial injury. This is due to scar tissue formation, which initially acts
like the glue to bond the tissue back together. Scar tissue will continue
to form past six weeks in some cases and as long as a year in severe cases.
After 6 months this condition is considered chronic and much more difficult to
treat. The initial approach to treating Achilles tendonitis is to support and protect
the tendons by bracing any areas of the tendon that are being pulled on during
use. It is important to loosen up the tendon, lessen the pain, and minimize any
inflammation.

This can be done topically if a pain reliever has the
ability to penetrate the skin barrier and contains anti-inflammatory agents. A
topical formula that contains natural menthol will not only relieve pain, but
dilate the blood vessels. This allows for relief of the tendonitis, without
causing any stiffening of the tissue. MSM, also known as Methyl Sulfonyl
Methane is a natural supplement that is getting a lot of attention due to its
role in tissue healing at a cellular level. It is a natural organic sulfur
that comes from rain fall and is found naturally in the human body. It has
been shown to have anti-inflammatory effects on the tissues. See
all about
Glucosamine and MSM for more information this supplement. Ice can relieve inflammation, but will
constrict the blood vessels and further stiffen the tendon. Cortisone injections
can reduce inflammation, but unfortunately are very caustic and can cause a
weakening of the tendon structure and a create more scar tissue. Dr.
Swartzburg, our site editor, worked in conjunction with our sponsor,
Relief-Mart, to develop a spray for Tendonitis called
Therapain Plus. It has all natural pain relievers plus 14,000mg of MSM and Glucosamine.

After the scar
tissue has begun to accumulate, it will be important to perform procedures which
help break down the scar tissue in the achilles tendon tissue, so as to let
the tendon and muscle regain it's normal flexibility and lessen the chance of further
injury. While exercise is appropriate for breaking down scar tissue once
the area has healed, it may further irritate the area during the initial stages.
Therefore, other methods that can be performed by your healthcare provider, such
as ultrasound and massage, may be safely used to accomplish this early on in the
injury. Ultrasound uses sound waves that vibrate a such a fast level, that it
cannot be felt with normal use. Ultrasound will cause an increase in
circulation to the tissue and soften the scar tissue to allow it to further
break down. Ultrasound can also be used as phonophoresis to help topical
pain and nutrient solutions reach further down into the tissues by transporting
them with the sound waves. Light stretches may also be performed if they do not cause any further
irritation to the area. Once the heavy inflammation has passed, the
stretches can become more vigorous and by design really stretch the calf muscle,
therefore helping to slacken the Achillies tendon (see proper Achilles stretch
below)

Start with stretching the right Gastrocnemius portion
of the right calf area. While standing, place your right leg in front of
you and your left foot directly behind you. Place the toes of your
right forefoot up against a door or other flat wall surface, keeping
your heel down to the floor. Lean your upper body forward to place a
stretch on the back of the calf. Do the exact opposite to achieve a
stretch of the left calf area. Hold each stretch for a minimum of 30
seconds. Any less than 15 seconds and the muscle will not conform to
the new increase in length. Do 3 reps, 3-6 times a day. Any pain you
feel with this exercise should only be a local stretching sensation to
the calf area of the leg, without aggravating your condition.

Achilles Tendonitis Prevention

Prevention of this condition requires stretching the
calf muscle on a regular basis and thereby lengthening the tendon connection. This
will allow less pulling and tractioning on the tendon attachment to the bone.
When tendonitis does occur, it is important to treat it immediately, and thereby
prevent it from reaching a stage that is more severe.

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